Clinical Trials: Glucosamine–Chondroitin Combo Improves Knee

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RESEARCH HIGHLIGHTS Nature Reviews Rheumatology 11, 126 (2015); published online 3 February 2015; doi:10.1038/nrrheum.2015.9

CLINICAL TRIALS Glucosamine–chondroitin combo improves knee OA pain

The efficacy of combined chondroitin MOVES included 606 patients at sites outcome measures of WOMAC stiffness sulphate plus glucosamine for knee in France, Germany, Poland and Spain score (46.9% decrease in the combination osteoarthritis (OA) is debated, but the who had radiographically evident knee group vs 49.2% in the celecoxib group; suggestion, from analysis of past clinical OA (Kellgren–Lawrence grade 2 or 3) P = 0.43) or WOMAC function score trials, that a subgroup of patients with and severe pain (WOMAC pain score (45.5% vs 46.4% decrease; P = 0.53). Joint moderate to severe pain might benefit ≥301 on a 0–500 scale). Owing to the use swelling and effusion were similarly from this therapy has now been further of celecoxib as one of the study drugs, decreased in both groups. explored in the phase IV MOVES individuals at high risk of cardiovascular Rates of adverse events were similar (Multicentre Osteoarthritis interVEntion or gastrointestinal events were excluded across the groups, and both treatments trial with Sysadoa) trial. The results of this from the trial. had good safety profiles and tolerability. latest study indicate that the combination Patients were randomly assigned to Of note, the safety and efficacy of the of chondroitin plus glucosamine has treatment with a prescription formulation prescription drug used in this study efficacy comparable to that of the of 400 mg chondroitin sulphate plus cannot be generalized to unregulated, cyclooxygenase‑2 inhibitor celecoxib in 500 mg glucosamine hydrochloride commercially available dietary relieving symptoms in patients with OA of (Droglican®, produced by Bioiberica SA, supplements, nor to the individual the knee with severe pain. Barcelona, who sponsored the MOVES components of the chondroitin– trial) three times a day or with 200 mg glucosamine combination. celecoxib (Celebrex®, Pfizer, New York) The authors conclude that the once a day plus placebo. combination therapy used in Although the celecoxib group had a the study “appears to be beneficial faster and more substantial response in in the treatment of patients with the first 4 months of the study, by the [OA] of the knee and should offer 6-month endpoint, responses were similar a safe and effective alternative for across both groups. The mean change those patients with cardiovascular or in WOMAC pain score at 6 months was gastrointestinal conditions”. –185.7 (50.1% decrease from baseline) Sarah Onuora in the chondroitin plus glucosamine group and –186.8 (50.2% decrease from baseline) in the celecoxib group; the mean Original article Hochberg, M. C. et al. Combined difference between the groups was −1.1 chondroitin sulfate and glucosamine for painful knee (95% CI −22.0 to 19.8; P = 0.92). osteoarthritis: a multicentre, randomised, double-blind, There were no significant differences non-inferiority trial versus celecoxib. Ann. Rheum. Dis. doi:10.1136/annrheumdis-2014-206792 Getty/iStockphoto/Thinkstock between the groups in the secondary